Provider Demographics
NPI:1073828125
Name:MILLER, JO ANNE (PTA)
Entity Type:Individual
Prefix:MS
First Name:JO ANNE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 SE 18TH AVE
Mailing Address - Street 2:APT 1008
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8240
Mailing Address - Country:US
Mailing Address - Phone:352-854-3370
Mailing Address - Fax:
Practice Address - Street 1:1190 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4510
Practice Address - Country:US
Practice Address - Phone:352-732-8868
Practice Address - Fax:352-732-8890
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA20060225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant